Pop Up Listen:
<script type='text/javascript'><!--//<![CDATA[
var m3_u = (location.protocol=='https:'?'https://x10radio.com/adserver/www/delivery/ajs.php':'http://x10radio.com/adserver/www/delivery/ajs.php');
var m3_r = Math.floor(Math.random()*99999999999);
if (!document.MAX_used) document.MAX_used = ',';
document.write ("<scr"+"ipt type='text/javascript' src='"+m3_u);
document.write ("?zoneid=1");
document.write ('&cb=' + m3_r);
if (document.MAX_used != ',') document.write ("&exclude=" + document.MAX_used);
document.write ("&loc=" + escape(window.location));
if (document.referrer) document.write ("&referer=" + escape(document.referrer));
if (document.context) document.write ("&context=" + escape(document.context));
if (document.mmm_fo) document.write ("&mmm_fo=1");
document.write ("'><\/scr"+"ipt>");
//]]>--></script><noscript><a href='http://x10radio.com/adserver/www/delivery/ck.php?n=a1b0dfb5&cb=456451286' target='_blank'><img src='http://x10radio.com/adserver/www/delivery/avw.php?zoneid=1&cb=456451286&n=a1b0dfb5' border='0' alt='' /></a></noscript>
<a href="listen.php" onclick="window.open('listen.php','popup','width=320,height=260,scrollbars=no,resizable=no,toolbar=no,directories=no,location=no,menubar=no,status=no,left=0,top=0'); return false"><b>Listen Live</b></a>
Form:
<form method='POST' action='bot.php'>
<b>Name:</b><br>
<input type="text" name="name"><p>
<b>Type:</b><br>
<select name="type">
<option selected>Song Request</option>
<option>Shoutout</option>
<option>Competition</option>
<option>Joke</option>
<option>Other</option>
</select><p>
<b>Request:</b><br>
<textarea cols='20' rows='7' name='request'></textarea><p>
<input type='submit' name='submit' value='Request'>
</form>
I helped you enough, you can transform the code into what you need, otherwise your not good enough at coding to win it.